Sleep 3

Question 1

Most common explanation by pts > 65 y/o for difficulty maintaining sleep?

Answer 1

Nocturia

Question 2

67 y/o w/ MDD doing well on SSRI, but continues to have insomina and sleepiness during day. Snores loudly, morning HAs, and night sweats.
Dx?

Answer 2

Breathing related sleep D/O

Question 3

Which measure of REM is typically reduced in MDD?

Answer 3

Sleep onset to REM onset

Question 4

MDD has what sleep abnormality?

Answer 4

Shortened REM latency
Decreased stage 4 sleep
Increased awakenings in 2nd half of night

Question 5

REM sleep behavior D/O associated w/ which pathology?

Answer 5

Parkinson’s disease

Question 6

Mainly a non-REM sleep problem

Answer 6

Enuresis

Question 7

Sinusoidal waves at 9-11 Hz on EEG is

Answer 7

Deep sleep

Question 8

Pt working overtime develops frightening nocturnal episodes characterized by semi-wakefulness and inability to move, accompanied by sense that an intruder is present. Pt denies daytime sleep attacks or loss of motor control.
Best initial tx?

Answer 8

Getting sufficient sleep

Question 9

Patient reports being “irritable” w/ inability to sleep more than 1 hr at night one wk after receiving 80 mg prednisone daily for poison ivy rash

Answer 9

Begin to gradually taper off prednisone

Question 10

Most effective tx for REM sleep behavior d/o?

Answer 10

Clonazepam

Question 11

Which aspect of sleep is increased in older adults?

Answer 11

Subjective quality

Question 12

Most effective tx for OSA?

Answer 12

Positive pressure therapy

Question 13

35 y/o recurrent episodes of awakening during sleep. Waking up w/ a panicked scream and sweating, racing HR, can’t remember, and daytime drowsiness affecting functioning.
EEG - normal.
Dx?

Answer 13

Sleep terrors